Evaluation-imaging

Imaging techniques to help in the evaluation of suprascapular nerve injury include the standard radiographic shoulder series, including an AP radiograph in which the beam is directed caudally by 15 to 30 degrees. The suprascapular notch also may be seen on the Stryker notch view.

Although plain radiographs usually are nondiagnositic, they can be useful both in assessing the morphology of the notch and in assessing for a calcified transverse scapular ligament or in revealing a callus after scapular or clavicle fracture that may irritate, tether, or compress the nerve. CT scans also may reveal osseous abnormalities affecting the nerve, including shape assessment of the notch, calcified ligament, or fracture callus.

MRI is best to define the anatomy of the soft tissues, to identify the course of the suprascapular nerve, and to determine the presence of any cysts or lesions compressing the nerve. The MRI is also useful to demonstrate rotator cuff atrophy and to rule out other internal derangement of the shoulder or causes of shoulder pain (e.g., rotator cuff tears). Ganglion cysts around the shoulder causing suprascapular nerve compression are estimated to be associated with labral tears, seen either arthroscopically or by MRI, in nearly 90% of cases.